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Hernia
Published in: Hernia 2/2015

Open Access 01-04-2015 | Original Article

Complex ventral hernia repair with a human acellular dermal matrix

Authors: J. S. Roth, C. Brathwaite, K. Hacker, K. Fisher, J. King

Published in: Hernia | Issue 2/2015

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Abstract

Purpose

The ideal approach to complex ventral hernia repair is frequently debated. Differences in processing techniques among biologic materials may impact hernia repair outcomes. This study evaluates the outcomes of hernia repair with a terminally sterilized human acellular dermal matrix (TS-HADM) (AlloMax® Surgical Graft, by C. R. Bard/Davol, Inc., Warwick, RI, USA) treated with low-dose gamma irradiation.

Methods

A single-arm multi-center retrospective observational study of patients undergoing hernia repair with TS-HADM was performed. Data analyses were exploratory only; no formal hypothesis testing was pre-specified.

Results

Seventy-eight patients (43F, 35M) underwent incisional hernia repair with a TS-HADM. Mean follow-up was 20.5 months. Preoperative characteristics include age of 56.6 ± 11.1 years, BMI 36.7 ± 9.9 kg/m2, and mean hernia defect size 187 cm2. Sixty-five patients underwent component separation technique (CST) with a reinforcing graft. Overall, 21.8 % developed recurrences. Recurrences occurred in 15 % of patients repaired with CST. Major wound complications occurred in 31 % of patients overall. Based upon CDC surgical wound classification, major wound complications were seen in 26, 40, 56, and 50 % of Class 1, 2, 3, and 4 wounds, respectively. No grafts required removal.

Conclusions

Hernia recurrences are not uncommon following complex abdominal wall reconstruction. Improved outcomes are seen when a TS-HADM is utilized as reinforcement to primary fascial closure.
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Metadata
Title
Complex ventral hernia repair with a human acellular dermal matrix
Authors
J. S. Roth
C. Brathwaite
K. Hacker
K. Fisher
J. King
Publication date
01-04-2015
Publisher
Springer Paris
Published in
Hernia / Issue 2/2015
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-014-1245-5

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